Placing implants is not a lengthy procedure, he said, and can be done under local anesthesia. This is important because patient does not experience a great deal of downtime; often they can return to work right away because swelling is not a problem.

Procedure An average of 7 to 8 mL of buffered lidocaine with epinephrine is injected in nasal dorsum, tip, and gingivallabial area. After 10 minutes, an incision is made in gingival-labial area and, tith sharp and blunt dissection, is tunneled up the columella. Then scissors and a periosteal elevator are used to undermine skin of nose and periosteum to create a pocket for implant.

Dr. Haddad used a preformed, L-shaped Silastic implant. "I like preformed models because they require almost no carving. Many surgeons will carve unformed Silastic at time of surgery. This usually takes longer and end results are not as pleasing as those achieved with preformed Silastic. I prefer Silastic over harder implants because feel is better," he explained.

Closing wound The wound is closed with chromic or polyglactin 910 (Vicryl) sutures. "if implants is placed deep the periosteum, then it is well secured," he said. If necessary, Steristrips can be placed on top of nose.

Projecting tip of nose will sometimes narrow nasal alae. If this does not occur after he places implant, then Dr. Haddad removes a wedge of skin at junction between nasal alae and floor of nose which he cuts from inside or from outside along crease of nostril.

Asian eyes also require special attention, and patient dictates outcome based not just on personal preference, but on cultural factors as well. (See Asian eye article on p.16). CST For Information:

1(877)500 - 2525 info@1cosmeticsurgery.com

Family members can help to preserve their loved one's skills and strengths by identifying areas of satisfaction and pleasure. Enabling your loved one to participate in activities which they have enjoyed their whole life can help to reduce agitation, improve their ability to cope with disease, and increase their sense of dignity. For example, if your loved one used to enjoy painting or gardening, set time aside to participate in these activities in a way that is safe and manageable. Activities that are as simple as being around pets, going for walks, and listening to music can help to positively structure time and enhance quality of life.

Lastly, watching video biographies are a great way to spend time with your loved one. Video biographies are old photographs that are videotaped and narrated by family members. These videos can often help to reduce agitation during a visit and possibly help to spark memory of person suffering from Alzheimer's Disease. There is a lot of room for creativity in constructing video biographies as well as opportunity to include multiple generations of family members in process.